PubMed İndeksli Yayınlar Koleksiyonu / PubMed Indexed Publications Collection
Permanent URI for this collectionhttps://hdl.handle.net/11147/7645
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Article Locoregional Treatment in De Novo Bone-Only Metastatic Breast Cancer: Prospective, Multi-Institutional Real-World Data, BOMETIN, Protocol MF14-1a(MDPI, 2025) Soran, Atilla; Demirors, Berkay; Aytac, Ozgur; Ozbas, Serdar; Dogan, Lutfi; Lucci, AnthonyIntroduction: The impact of locoregional treatment (LRT) on survival in de novo bone-only metastatic breast cancer (dnBOMBC) is controversial. This study aims to assess the effect of LRT on survival, utilizing international, prospectively acquired data in this cohort of patients. Materials and Methods: Patients with dnBOMBC were divided into two groups: those receiving systemic therapy only (ST) and those undergoing LRT. Further, patients who received LRT were divided into two subgroups: those who received ST after LRT (LRT+ST group) and those who received ST prior to LRT (ST+LRT group). Factors associated with disease progression, including solitary or multiple bone metastases, were analyzed. Results: There was a total of 744 patients with dnBOMBC treated at each of the participating institutions between 2014 and 2022, with 372 (50%) participants in each arm. Median follow-up was 48 months (32-66, 25-75%). Patients in the LRT group were significantly younger than the ST group [50 (42, 60) vs. 55 (44, 66), p = 0.0001]. There were no significant differences in grade, HER2 status, triple-negative status, receipt of hormonal therapy, or intervention to metastatic sites. During follow-up, 58% (n = 217) of patients in the ST group and 32% (n = 120) of patients in the LRT group died (p < 0.001). Local progression was observed in 20% of the patients in the ST group, whereas 9% progressed in the LRT group (p = 0.0001). Systemic progression occurred more in the ST group; 66% (n = 244) compared to 41% (n = 152) of patients in the LRT group (p < 0.001). The hazard of death was 64% lower in the LRT group than in the ST group (HR: 0.36, 95% CI: 0.29-0.45, p < 0.0001). The burden of metastatic disease differed significantly between the two groups, with a higher rate of solitary bone metastases in the LRT group compared to the ST group (50% vs. 24%, p < 0.001). However, the LRT group had better overall survival (OS) for both solitary (HR: 0.38, 95% Cl: 0.26-0.55) and multiple (HR: 0.38, 95% Cl: 0.29-0.51) bone metastasis patients. Within the LRT group, survival rates were similar whether the breast surgery was performed before or after ST. Multivariate Cox analysis showed that LRT and ER/PR positivity significantly decrease the hazard of death (p < 0.05). Conclusions: Analysis of this large multi-institutional patient cohort provides further evidence that LRT is associated with longer OS and lower locoregional recurrence rates in patients with dnBOMBC. In breast cancer patients with bone-only metastases at presentation, the decision for LRT should be made through a multidisciplinary approach with consideration of surgical therapy at the primary tumor.Erratum Correction: Intervention for Hepatic and Pulmonary Metastases in Breast Cancer Patients: Prospective, Multi-Institutional Registry Study–imet, Protocol Mf 14-02(Springer, 2023) Soran, Atilla; Özbaş, Serdar; Özçınar, Beyza; Işık, Arda; Doğan, Lütfi; Şenol, Kazım; Sezgin, EfeThe authors‘ given names are correct as reflected here. © Society of Surgical Oncology 2022.Article Citation - WoS: 1Aso Visual Abstract: Intervention for Hepatic and Pulmonary Metastases in Breast Cancer Patients-Prospective, Multi-Institutional Registry Study: Imet; Protocol Mf 14-02(Springer, 2022) Soran, Atilla; Özbaş, Serdar; Özçınar, Beyza; Işık, Arda; Doğan, L.; Şenol, Kazım; Dağ, Ahmet; Karanlık, Hasan; Aytaç, Özgür; Karadeniz Çakmak, Güldeniz; Dalcı, Kubilay; Doğan, Mutlu; Sezer, Atakan Y.; Gökgöz, Şehsuvar; Özyar, Enis; Sezgin, EfeThe aim of our prospective, multicenter registry study was to investigate the importance of interventions for operable lung and/or liver metastasis for breast cancer (BC) survival (https://doi.org/10.1245/s10434-022-12239-z). The results reveal that surgical resection or ablative interventions may contribute to survival in patients with BC with limited number and operable metachronous hepatic/pulmonary metastases. Ultimately, randomized studies will determine whether intervention on lung and liver metastatic sites should be performed. In the meantime, such interventions can be considered on select patients.Letter Citation - Scopus: 3Reply: the Effect of Primary Surgery in Patients With Stage Iv Breast Cancer With Bone Metastasis Only (protocol Bomet Mf 14-01): a Multi-Center, Registry Study(Springer, 2021) Soran, Atilla; Sezgin, Efe; Özbaş, Serdar; Doğan, LütfiDear Editor, We’d like to thank Drs. Ishizuka and Horimoto for their letter to the editor. We’re glad to see their interest to our prospective study. Regarding their recommendation that univariate Kaplan–Meier analysis does not eliminate confounding factors, such as age, tumor size, number of bone metastasis, etc., we employed propensity score methods for the results, including Fig. 1.Letter Citation - WoS: 1Citation - Scopus: 1Correspondence To "Locoregional Therapy in De Novo Metastatic Breast Cancer: Systematic Review and Meta-Analysis, Written by Reinhorn D Et Al. in the Breast Journal 58 (2021) 173-181(Churchill Livingstone, 2021) Soran, Atilla; Ozbas, Serdar; Dogan, Lut; Isik, Arda; Sezgin, EfeConference Object Citation - WoS: 83Citation - Scopus: 87Primary Surgery With Systemic Therapy in Patients With De Novo Stage Iv Breast Cancer: 10-Year Follow-Up; Protocol Mf07-01 Randomized Clinical Trial(Elsevier, 2021) Soran, Atilla; Özmen, Vahit; Özbaş, Serdar; Karanlık, Hasan; Müslümanoğlu, Mahmut; İğci, Abdullah; Cantürk, Nuh Zafer; Utkan, Zafer; Evrensel, Türkkan; Sezgin, EfeBackground: The aim of this randomized clinical trial was to evaluate the overall survival (OS) data of patients diagnosed with de novo stage IV breast cancer (BC) who received locoregional treatment (LRT) over a 10-year follow-up. Study Design: The MF07-01 is a 1:1 multicenter, randomized clinical trial comparing the LRT with systemic therapy (ST), where ST was given to all patients either immediately after randomization or after surgical resection of the intact primary tumor. Results: A total of 278 patients were randomized and 265 patients were in the final analysis. At 10-year follow-up, survivals were 19% (95% CI 13%–28%) and 5% (95% CI 2%–12%) in the LRT group and ST group, respectively. Median survival was 46 months for the LRT group and 35 months for the ST group, and hazard of death was 29% lower in the LRT group compared with the ST group (hazard ratio [HR] 0.71; 95% CI 0.59–0.86; p = 0.0003). Conclusions: Patients with a diagnosis of de novo stage IV BC who underwent LRT followed by ST had a 14% higher chance of OS by the end of the 10-year follow-up compared with the patients who received only ST. The longer study follow-up revealed that LRT should be presented to patients when discussing treatment options. © 2021 American College of SurgeonsArticle Citation - WoS: 260Citation - Scopus: 293Randomized Trial Comparing Resection of Primary Tumor With No Surgery in Stage Iv Breast Cancer at Presentation: Protocol Mf07-01(Springer, 2018) Soran, Atilla; Özmen, Vahit; Özbaş, Serdar; Karanlık, Hasan; Müslümanoğlu, Mahmut; İgci, Abdullah; Johnson, Ronald; Sezgin, EfeThe MF07-01 trial is a multicenter, phase III, randomized, controlled study comparing locoregional treatment (LRT) followed by systemic therapy (ST) with ST alone for treatment-na < ve stage IV breast cancer (BC) patients. At initial diagnosis, patients were randomized 1:1 to either the LRT or ST group. All the patients were given ST either immediately after randomization or after surgical resection of the intact primary tumor. The trial enrolled 274 patients: 138 in the LRT group and 136 in the ST group. Hazard of death was 34% lower in the LRT group than in the ST group (hazard ratio [HR], 0.66; 95% confidence interval [CI], 0.49-0.88; p = 0.005). Unplanned subgroup analyses showed that the risk of death was statistically lower in the LRT group than in the ST group with respect to estrogen receptor (ER)/progesterone receptor (PR)(+) (HR 0.64; 95% CI 0.46-0.91; p = 0.01), human epidermal growth factor 2 (HER2)/neu(-) (HR 0.64; 95% CI 0.45-0.91; p = 0.01), patients younger than 55 years (HR 0.57; 95% CI 0.38-0.86; p = 0.007), and patients with solitary bone-only metastases (HR 0.47; 95% CI 0.23-0.98; p = 0.04). In the current trial, improvement in 36-month survival was not observed with upfront surgery for stage IV breast cancer patients. However, a longer follow-up study (median, 40 months) showed statistically significant improvement in median survival. When locoregional treatment in de novo stage IV BC is discussed with the patient as an option, practitioners must consider age, performance status, comorbidities, tumor type, and metastatic disease burden.Article Citation - WoS: 87Citation - Scopus: 94Factors Related To Recurrence of Idiopathic Granulomatous Mastitis: What Do We Learn From a Multicentre Study?(John Wiley and Sons Inc., 2018) Uysal, Erdal; Soran, Atilla; Sezgin, Efe; Granulomatous Mastitis Study GroupBackground: Idiopathic granulomatous mastitis (IGM) is a rare chronic inflammatory disease of the breast with unknown aetiology. Its treatment is controversial and the recurrence rate is high. The objectives of this study were to examine the demographic, sociocultural and clinical characteristics observed among a large cohort of IGM patients from Turkey and to identify factors related to the recurrence of IGM. Methods: The study was designed as a multicentre retrospective study including 22 breast centres in Turkey. A total of 720 IGM patients are included in the study. Patient data were obtained from the patient's files and electronic records based on the study protocol. Patients’ demographic, clinical, radiological, treatment and recurrence of IGM related characteristics were recorded. Results: Our results revealed a statistically significant association between IGM recurrence and history of pregnancy, breastfeeding, breast infection and smoking (P < 0.05). Having a chronic systematic disease, oral contraceptive, analgesic and herbal medicine consumptions, treatment choice, education, place of birth and current residence were not found to be associated with IGM recurrence (P > 0.05). Conclusion: Our findings show that history of pregnancy, breastfeeding, breast infection and smoking were the risk factors for IGM recurrence. As current treatment methods did not affect IGM recurrence, recurrence-related factors, such as breast infection and smoking, should be considered to eliminate while focusing on less invasive local treatment research.Article Citation - Scopus: 37The Impact of Onco Type Dx® Recurrence Score of Paraffin-Embedded Core Biopsy Tissues in Predicting Response To Neoadjuvant Chemotherapy in Women With Breast Cancer(IOS Press, 2016) Soran, Atilla; Bhargava, Rohit; Johnson, Ronald; Ahrendt, Gretchen; Bonaventura, Marguerite; Diego, Emilia; McAuliffe, Priscilla F.; Serrano, Merida; Menekşe, Ebru; Sezgin, Efe; McGuire, Kandace P.BACKGROUND: Oncotype DX® test is beneficial in predicting recurrence free survival in estrogen receptor positive (ER+) breast cancer. Ability of the assay to predict response to neoadjuvant chemotherapy (NCT) is less well-studied. OBJECTIVE: We hypothesize a positive association between the Oncotype DX® recurrence score (RS) and the percentage tumor response (%TR) after NCT. METHODS: Pre-therapy RS was measured on core biopsies from 60 patients with ER+, HER2.. invasive breast cancer (IBC) who then received NCT. Pre-therapy tumor size was measured using imaging. %TR, partial response (PR; 50%), pathologic complete response (PCR) and breast conserving surgery (BCS) rates were measured. RESULTS: Median RS was 20 (2 69). Median %TR was 42 (0 97)%. PR was observed in 43% of patients. There was no association between %TR and pre-NCT tumor size, age, Nottingham score or nodal status (p 0:05). No statistically significant association with %TR was seen with RS as a categorical or continuous variable (p = 0:21 and 0.7, respectively). Response to NCT improved as ER (p = 0:02) by RT-PCR decreased. Lower ER expression by IHC correlated with response (p = 0:03). CONCLUSIONS: In patients with ER+ IBC receiving NCT, RS did not predict response to NCT using %TR. The benefit of the assay prior to NCT requires further study.